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Understanding Pathophysiology, 6th Ed., Huether, McCance, Brashers, & Rote | Registered Nurse (RN) School Study Aid


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41 - Structure, Function, and Disorders of the Integument
22 Picmonics to Learn | 44 mins
Skin Anatomy
Characteristics
Epidermis
Keratinocytes
Melanocytes
Dendritic Cells
Merkel Cells
Dermis
Sweat Glands
Hair Follicles
Sebaceous Glands
Hypodermis
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3 mins
Skin Functions
Characteristics
Thermoregulation
Protection
Innate Immune Protection
Synthesize Vitamin D
Water and Salt Excretion
Dilated Capillaries are a Blood Reservoir
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2 mins
Pressure Ulcers
Types
Stage 1 - Non-Blanchable Redness
Stage 2 - Partial Thickness
Stage 3 - Full Thickness Skin Loss
Stage 4 - Full Thickness Tissue Loss
Unstageable
Possible Deep Tissue Injury
Considerations
Skin Color Alterations
Remove Necrotic Tissue Before Staging
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2 mins
Atopic Dermatitis / Eczema
Presentation
Pruritic Vesicles
Inflammatory Skin Rash
Cheeks in Children
Skin Flexural Areas
Associated with Asthma and Allergic Rhinitis
Treatment
Tacrolimus
Moisturizers
Corticosteroids
Phototherapy
Avoid Triggers
Antihistamines
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2 mins
Psoriasis
Presentation
Epidermal Hyperproliferation Keratinocytes
Defined Red Salmon Plaques
Silvery Scales
Extensor Surfaces
Bleeding when Removed
Auspitz Sign
Pruritus
Nail Changes
Histological Finding
Munro Microabscesses
Nucleated Cells in Stratum Corneum
Treatment
Retinoids
Topical Corticosteroids
Tar
Immunosuppressants
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2 mins
Systemic Lupus Erythematosus (SLE) Assessment
Mechanism
Multisystem Inflammatory Disorder
Assessment
Malar Rash
Discoid Rash
Arrhythmias
Arthritis
Hemolytic Anemia
Seizures
Glomerulonephritis
Considerations
Periods of Exacerbation and Remission
Diagnosed by ANA (Anti-nuclear antibody assay)
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2 mins
Systemic Lupus Erythematosus (SLE) Interventions
Avoid Sunlight
Drug Therapy
Glucocorticoids
Methotrexate
NSAIDs
Hydroxychloroquine
Azathioprine
Considerations
Monitor for Renal Failure (ARF)
Manage Pain
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2 mins
Lyme Disease
Mechanism
Transmitted by Ticks (Vector-borne)
Signs and Symptoms
Flu-like Symptoms
Bulls Eye Rash (Erythema Migrans)
Joint Pain and Stiffness
Facial Paralysis
Considerations
Antibiotics
Prevention
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2 mins
Herpes Simplex Virus (HSV)
Characteristics
Enveloped
Double Stranded DNA
Linear
Signs and Symptoms
Type 1 HSV
Gingivostomatitis
Keratoconjunctivitis
Encephalitis of Temporal Lobes
Latent in Trigeminal Ganglia
Type 2 HSV
Genital Vesicles
Neonatal Herpes
TORCHES
Latent in Sacral Ganglia
Diagnosis
Tzanck Test
Multinucleated Giant Cells
Cowdry A Inclusions
Treatment
Acyclovir
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2 mins
Herpes Zoster (Shingles)
Cause/Mechanism
Varicella-Zoster Virus
Assessment
Linear, Unilateral Rash Along a Dermatome
Pruritus
Postherpetic Neuralgia
Interventions
Acyclovir
Analgesics
Gabapentin
Considerations
Contagious Vesicles
Shingrix
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3 mins
Varicella (Chickenpox)
Mechanism
Varicella Zoster Virus (VZV)
Signs and Symptoms
Red Maculopapular Rash
Vesicles Ooze and Crust
Pruritus
Centripetal
Considerations
Varicella Immunization
Skin Care to Minimize Itching
Isolate until Vesicles Crust
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2 mins
Varicella Zoster Virus (VZV)
Herpesvirus 3
Characteristics
Enveloped
Double Stranded DNA
Signs and Symptoms
Chickenpox
Pneumonia
Encephalitis
Trigeminal and Dorsal Root Ganglia
Shingles
Diagnosis
Tzanck Test
Multinucleated Giant Cells
Cowdry A Inclusion
Treatment
Acyclovir
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2 mins
Human Papillomavirus (HPV)
Characteristics
Non-enveloped
Circular
Double Stranded DNA
Disease
Warts 1, 2, 6, 11
Condyloma acuminata
Type 16, 18
Cervical Carcinoma
Penile Carcinoma
AIDS/Immunocompromised
Worsened by Smoking
Diagnosis
Koilocytic change in squamous epithelium
Pyknotic Nuclei Surrounded by Clear Halo
Treatment
Vaccine Available
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4 mins
Cancer Warning Signs (CAUTION)
CAUTION
Change in Bowel or Bladder Habits
A Sore That Does Not Heal
Unusual Bleeding or Discharge
Thickening or Lump in the Breast or Elsewhere
Dyspepsia (Indigestion)
Obvious Change to Warts or Moles
Nagging Cough
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1 min
ABCDEs of Melanoma
Asymmetry
Border
Color
Diameter
Evolving
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1 min
Rule of 9's for Burns
Total Body Surface Area (TBSA)
Head
Anterior Torso (18%)
Chest
Abdomen
Posterior Torso (18%)
Upper Back
Lower Back
Extremities
Posterior Leg (each)
Anterior Leg (each)
Each Arm
Genitalia 1%
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2 mins
Parkland Formula
Burn victims
24 hours
TBSA% x Weight x 4 = Fluids
TBSA %
x Weight (kg)
x 4
= Fluid Requirement (in first 24 hrs)
Fluids in first 8 hours
1/2 of fluid given in first 8 hours
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1 min
Types of Burns
Superficial Thickness
Sunburn
Superficial Partial Thickness
Blisters
Blanching
Deep Partial Thickness
Little or Non-blanching
Full Thickness
Waxy white, yellow or black
Decreased Pain
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2 mins
Stages of Burn Care
Phase / Stage 1
Resuscitative/Emergent Phase
Injury to Return of Capillary Permeability
48-72 hours
IV Fluid Replacement
Phase / Stage 2
Acute Phase
Diuresis to Near Wound Closure
Phase / Stage 3
Wound Closure to Return of Optimal Level
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2 mins
Burns Assessment
Stage and Extent of Burn
Dyspnea
Singed Nasal Hairs
Pain
Initial Decrease Urinary Output
Paralytic Ileus
Signs of Inadequate Hydration
Shock
Hypothermia
Hyperkalemia
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2 mins
Burns Interventions
Ensure Airway Patency
O2
IV Fluid Replacement
Dry Sterile Dressing
Debridement
Elevate Burned Limbs
Analgesics
Silver Sulfadiazine
Escharotomy
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2 mins
Burns Considerations
Maintain Body Temperature
Increased Risk of Infection
Venous Thromboembolism (VTE) Prophylaxis
Curling's Ulcer
Excision and Grafting
Adequate Nutrition
Contractures
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2 mins

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